Controlled drugs Flashcards
Legislation
Misuse of Drugs Act 1971
– possession, supply, manufacture, import and export of CDs
Legislation
Misuse of Drugs Regulations 2001
– exemptions from above and classifications
Legislation
Misuse of Drugs Regulations 1973
– safe custody and storage of CDs
Legislation
The Health Act 2006
– ‘accountable officer’ and Standard Operating Procedure for CDs
Legislation Controlled Drugs (Supervision of Management and Use) Regulations 2013
– duties of the Accountable Officer
Which schedule CDs should be kept in safe custody?
Most schedule 2 and some schedule 3
How do prisons and hospitals store CDs?
Sold secure silver standard
Hospitals carry a lot more CD’s than community pharmacies
Hospital’s are more secure than community
CD registers
Head of each page must specify
– Class (i.e. drug)
– Strength
– Form (e.g modified release)
CD registers
How are different classes entered into a CD register?
• Different classes in separate registers
• Within class separate page for:
– Different strengths
– Different formulations of each drug
CD registers
When should an entry be made and in what?
Chronological order – entries on the day or if you don’t have time on the day then it should be made on the following working day
Should be made using Ink or indelible, not pencil
CD registers
How to make an alteration?
Can’t cross anything out or use tipex in a CD register
Correct method of correcting a mistake is to put the incorrect entry into brackets and put an astrix next to it and then put an astrix in the footnote and write the correct entry and put your GPhC number, initials/signature and date
What is recorded in a CD Register
• Receipts
– Date
– Supplier (can record invoice number for supplier - good practice)
– Quantity
What is recorded in a CD Register
• Supplied
– Date
– Name and address of recipient
– Details of authority to possess (prescriber’s details)
– Quantity
– Person collecting (if its a health care professional collecting then their name and address should be recorded)
– ID requested (if you don’t know the person)
– ID provided
What are the classifications of CDs
• Schedule 1 (CD lic POM) • Schedule 2 (CD POM) • Schedule 3 (CD no reg POM) • Schedule 4 – part 1 (CD benz POM) ‐‐ part 2 (CD anab POM) • Schedule 5 (CD inv P or CD inv POM)
Schedule 1
- POM
- Licence needed from Home Office
- No therapeutic use
- LSD, cannabis, ecstasy etc.
Schedule 2
• POM
• Opiates
• Major stimulants (amphetamines, quinalbarbitone)
• Must be recorded in CD register
• Safe custody
– Except some liquid preparations and quinalbarbitone
• Destruction
– Denature
– Need an authorised witness and CD entry
Prescription requirements for Schedule 2
• Prescription validity ‐ 28 days from the date of supply • Private prescription (FP10PCD) and standard requisition • Prescriber’s address – UK–yes – EEA – cannot prescribe • No prescription repeats • No Emergency Supply allowed • ID for person collecting prescription required – sign the back of the prescription
Schedule 3
• POM • Minor stimulants and other drugs • Not recorded in CD register • Safe custody – unless exempt • Destruction – Denature – No authorised witness required and no need to enter in CD register – Good practice to have a witness and a record
Prescription requirements for Schedule 3
• Prescription validity – 28 days
• Private prescription (FP10PCD) and standard requisition
• Prescribers address
– UK – yes
– EEA – cannot prescribe
• No prescription repeats
• No Emergency Supply allowed – except phenobarbital for epilepsy
Schedule 4
•POM • Part 1 - Benz • Part 2 - Anabolic • Not recorded in the CD register • Safe custody – not required • Destruction – no authorised witness required and no need to enter in CD register • For Part 1 (CD Benz POM) – Good practice to have a witness and a record
Prescription requirements for Schedule 4
• No prescription requirements • Prescription validity – 28 days • Private prescription (FP10PCD) and standard requisition not required • Prescribers address – UK not required – EEA ‐ yes • Prescription can be repeated • Emergency Supply allowed
Schedule 5
• Invoice P/POM • Treat as P or POM products E.g. • Liquids – Morphine less than 13mg/5mL • Solids – Co‐codamol 8/500 tablets (32 pack = P, more = POM) – Co‐codamol 30/500 ‐ POM
Prescription Requirements Schedules 2 and 3
1) Prescriber’s signature
2) Date (only valid for 28 days) Same restriction for Schedule 4
3) Prescriber’s address must be in UK
4) Dose must specify a quantity and frequency even if very
vague
– Apply every 72 hours – NO
– Apply ONE every 72 hours – YES
– Take as directed–NO
– Take ONE as directed – YES
5) Form – even if only one form available
– Pethidine – NO
– Pethidine tabs‐YES
6) Strength – only if more than one strength
– Pethidine tablets – YES as only 50 mg available
7) Total quantity in words and figures
– quantity should not exceed 30 days supply (not a legal requirement, but prescriber must justify)
– Pharmacist can add one or other if missing (not both) and can correct spelling mistakes (technical errors)
– Liquids should be expressed in millilitres
8) Patient’s name
– Age is same as POM regulations – if under 12
9) Patient’s address
– NFA or no fixed abode – YES
– PO Box – NO
10) Dental prescriptions for dental treatment only
Is the name of medicine a legal requirement on prescription
No
Private prescription requirements
– FP10PCD – patient’s NHS number and prescriber’s identification number (different from NHS number it will be 6 digits beginning with 6)
– Send to NHSBSA at end of month
– Does not apply to vets
– Within hospital supply standardised form not required
• PHARMACIST MUST ENDORSE PRESCRIPTION WITH DATE SUPPLIED
Requisition Form – Schedule 2 and 3
• Standard form is needed if request is from hospital, prescriber, veterinary surgeon (all legal) or another community pharmacy(not legal)
• Not needed if within hospital, hospice, prison or from a wholesaler
• Emergency supply
– GP can be supplied Schedule 2 and 3 but the requisition
must be received within 24 hours • Messenger
– Authorisation to carry – supplying pharmacist must keep for 2 years
• Send to NHSBSA end of month
Destruction Schedule 2
• Schedule 2 (except patient returns)
– Authorised Person – GPhC inspector, police, area managers (Accountable Officer can appoint)
– Denature
• CD entry – Date, quantity, signed by authorised person
Schedule 2 patient returns
– Denature
– Witness and record (Separate book – not CD register)
Destruction Schedule 3
– Denature
– Witness and record (Separate book – not CD register)
• Ampoules, patches, aerosols, methadone bottles
Destruction Schedule 4 part 1
– Denature
– Witness and record (Separate book – not CD register)
• Ampoules, patches, aerosols, methadone bottles
Fentanyl
Schedule 2 (safe custody)
Morphine
Schedule 2 (safe custody except liquid strength below 13mg/5ml)
Tapentadol
Schedule 2
Hydromorphone
Schedule 2 (safe custody)
Methylphenidate
Schedule 2 (safe custody)
Temazepam
Schedule 3
Buprenorphine
Schedule 3 (safe custody)
Pentazocine
Schedule 4 (no safe custody)
Tramadol
Schedule 4 (no safe custody)
Diazepam
Schedule 4 (part 1)
Zopiclone
Schedule 4 (part 1)
Codeine
Schedule 5 (no safe custody)
